AGEP

Question 1

incidence of AGEP per year

Answer 1

1-5/ million cases per year

Question 2

Genetic predispositition of what genes have more assoc w AGEP.

Answer 2

HLA B51, DR11, DQ3.

Question 3

lesions.

Answer 3

eruption evilves and disseminates rapidly. more than 100 non follicular pinpoint pustules less than 5mm.
Dermoscopy may aid in identifying pustules.

Question 4

lab abnormality in AGEP.

Answer 4

Leukocytosis. Neutrophilia (90%)

eosinophilia (30%)

Question 5

Freq implicated meds:

Answer 5

Antibiotics penicilline macrolide classes plus clindamycin minocycline sulfo antimycotic vanco quinolone antiepileptic antihypertensive CCB diltiazem hydroxychloroquine
steroid allopurino” oxicam nsaid pseudoephedrine terazosine omeprazole sennoside

Question 6

Histo

Answer 6

early lesion- papillary edema; neurtrophil clusters in dermal ppillae and perivasc eosinophil.

Question 7

AGEP TX

Answer 7

Most pxs- topical steroid, anti histamine
over 1/3 of cases, systemic corticosteroid may be req.
severe- Cyclosporine, infliximab, etanercept.

Question 8

Immunologic urticaria is mst often assoc w what drugs

Answer 8

penicillin; and related B lact antibiotics.

Question 9

known complicafion if acei and arbs.

Answer 9

Angioedema

Lisinopril and enalapril > captopril

Question 10

most common drugs that cause photosensitivity reactions ( photosenstive drug reactions)

Answer 10

NSAID tmpsmz thiazide diuretixs sulfonylureas quinine quinidine phenothiazine tetracycline

Question 11

NSAID freq assoc w photosensitivity

Answer 11

Piroxicam.

Question 12

Histo

Answer 12

Spongiosis, exocytosis, perivasc inflamm cells

Question 13

Which fluoroquinolone is highly photosensitizing

Answer 13

Sparfloxacin.

Mildly- enoxacin, ciprofloxafin; sitafloxacin.

Question 14

drug rep to induce photoleukomelanoderma - a mosaic mix of hypo/ hyperpigmentTion after erythema in sun exposed areas.

Answer 14

Flutamide

Question 15

% affected a voriconazole after more than 12 weeks intake/

Answer 15

8-10%

Question 16

Photodistributed telangiectasis is a rare complicarion of whT drug class

Answer 16

CCB ( nifedipine, felodipine, amlodipine)

Question 17

syndrome hase been seen w injection of many unrelated agents inc nsaid, loc anesthetic; steroi, antibiotic, ifn alpha, segatives vaccine MPA

Answer 17

Nicolau syndrome

Question 18

3 types od hyperpigmentation in Minocycline.

Answer 18

1 - blue black discoloration. most common.
2- Appearancd of a similar colored pigmentatuon in the normal skin of the anterior shins.
In most cases type 1 and 2 minocycline pigmentation occur after 3 months to several yrs of tx. Histo: pigment granules in macrophages.
3- least coommon type. Generalized muddy brown hyperpigmentation accentuated on sun exposed areas.

minocycline also causes dental hyperpigmentatuon. midportion of the tooth.

Question 19

The ff drugs all may cause blue black pigmentation of the face, extremities, cartilage, oral mucosa and nails i upto 29% of pxs.

Answer 19

Chloroquine, hydroxychloroquine, quinacrine.

Question 20

drug cauaes photosensitivity in 30-57% of tx pxs in 3-6 mos. in 1-10% of pxs, slate gray hyperpigmentation dev in the areas of photosensitivity. pigmentation grad fades aftr med discontinued.
Histo PAS positive, yellow brown granules seen in cytoplasm of macrophage

Answer 20

Amiodarone

Question 21

drug prod pink discoloration and hrad becomes reddishblue or brown. Histo: PAS positive, brown hranular pigment seen within foay macrophages.
“deug induced lipofucsinosis”

Answer 21

Clofazamine

Question 22

blue or brown hyperpig most freq on nails.

Answer 22

zidovudine

Question 23

most common heavy metal induced pigmentation by derma.

Answer 23

Silver.

Question 24

deugs cause a slate gray hyperpig in sun exposed areas after long periods of ingestion

Answer 24

Chlorpromazine
thioridazine
imipramine
clomipramine

Question 25

deug cause photodistributed hyprpig. most common in african american or hispanic women. and occurs after 1 yr after starting a tx. lesions are slate gray or gray blue macules and patches on the face, neck l, forearms. perifollicular accentuation.

Answer 25

CCB diltiazem

Question 26

drugs that cauae serum sickness like rxn

Answer 26

cefaclor 
b lactM 
minocycline 
bupropion 
influenza vaccine 
nsaid 
rituximab